Anomalies of the P1 segment of the posterior cerebral artery: Early bifurcation or duplication, fenestration, common trunk with the superior cerebellar artery

1991 ◽  
Vol 109 (1-2) ◽  
pp. 66-71 ◽  
Author(s):  
G. Caruso ◽  
F. Vincentelli ◽  
P. Rabehanta ◽  
G. Giudicelli ◽  
F. Grisoli
2020 ◽  
Vol 9 (2) ◽  
pp. 1789-1796
Author(s):  
Mickey Banda ◽  
Caswell Hachabizwa ◽  
Joseph Hainza ◽  
Sikhanyiso Mutemwa ◽  
Krikor Erzingastian

The superior cerebellar artery usually arises from the terminal end of the basilar artery. It may also originate from the posterior cerebral artery and or from a common trunk with the posterior cerebral artery. The anatomical variations of superior cerebellar artery show ethnic differences, but there are few reports on African populations in particular none from Zambia. Variations of the superior cerebellar artery might cause compression symptoms of cranial nerves III, IV and V. Furthermore, the presence of such variations has been considered to be a factor in the aetiology of  aneurysms and thrombus formation leading to cerebellar infarcts. The objectives of the study were to explore anatomical variations on the origin of the superior cerebellar artery; to measure the outer diameter at its origin and the length of superior cerebellar artery to its first bifurcation; to establish the presence of duplication , triplication , hypoplasia , agenesis , fenestration and any other anomalies that were detectable. This was a descriptive cross-sectional study in which 46 post-mortem human cadaveric brains were systematically sampled. A total of 113 superior cerebellar arteries were identified in 42 male and four female cadavers of age ranging between 18 and 65 years (mean 34.05±9.237mm). Superior cerebellar artery arose from the basilar artery as a single vessel in 49.5%, the common trunk arose in 6.2% and posterior cerebral artery origin was seen in 5.7%. Overall duplication of the superior cerebellar artery was seen in 35.5% and triplication in 5.3%. Nineteen (16.8%) of the superior cerebellar arteries were hypoplastic (less than 1mm) and ninety-four (83.2%) were normal. The diameter of the superior cerebellar artery at its origin ranged 0.25mm to 2.48mm (mean 1.42±0.54mm). The length of the superior cerebellar artery to its first bifurcation ranged from 3.77mm to 33.53mm (mean 21.92±7.40mm). Statistically, gender had no significant association of superior cerebellar artery variations (p>0.05). This knowledge will improvediagnosis and management of patients with vascular disorders of the posterior circulation. The newly identified patterns could be a contribution to the SCA classification system. Key words: Superior cerebellar artery, duplication, triplication and hypoplasia


Neurosurgery ◽  
2009 ◽  
Vol 64 (3) ◽  
pp. E564-E565 ◽  
Author(s):  
Marco A. Zanini ◽  
Vitor M. Pereira ◽  
Mauricio Jory ◽  
José G.M.P. Caldas

Abstract OBJECTIVE A giant fusiform aneurysm in the posterior cerebral artery (PCA) is rare, as is fenestration of the PCA and basilar apex variation. We describe the angiographic and surgical findings of a giant fusiform aneurysm in the P1–P2 PCA segment associated with PCA bilateral fenestration and superior cerebellar artery double origin. CLINICAL PRESENTATION A 26-year-old woman presented with a 2-month history of visual blurring. Digital subtraction angiography showed a giant (2.5 cm) fusiform PCA aneurysm in the right P1–P2 segment. The 3-dimensional view showed a caudal fusion pattern from the upper portion of the basilar artery associated with a bilateral long fenestration of the P1 and P2 segments and superior cerebellar artery double origin. INTERVENTION Surgical trapping of the right P1–P2 segment, including the posterior communicating artery, was performed by a pretemporal approach. Angiograms performed 3 and 13 months after surgery showed complete aneurysm exclusion, and the PCA was permeated and filled the PCA territory. Clinical follow-up at 14 months showed the patient with no deficits and a return to normal life. CONCLUSION To our knowledge, this is the first report of a giant fusiform aneurysm of the PCA associated with P1–P2 segment fenestration and other variations of the basilar apex (bilateral superior cerebellar artery duplication and caudal fusion). Comprehension of the embryology and anatomy of the PCA and its related vessels and branches is fundamental to the decision-making process for a PCA aneurysm, especially when parent vessel occlusion is planned.


2013 ◽  
Vol 118 (5) ◽  
pp. 1053-1057 ◽  
Author(s):  
Ana Rodríguez-Hernández ◽  
Christina Huang ◽  
Michael T. Lawton

Iatrogenic pseudoaneurysms are rare but serious complications of transsphenoidal surgery, and an iatrogenic pseudoaneurysm of the posterior cerebral artery (PCA) has been reported just once in the literature. The authors encountered such a case with a new P1 segment PCA pseudoaneurysm after endoscopic transsphenoidal resection of a pituitary adenoma. The aneurysm proved ideal for a novel intracranial–intracranial bypass in which the superior cerebellar artery (SCA) was used as an in situ donor artery to revascularize the recipient P2 segment. The bypass allowed aneurysm trapping without causing ischemic stroke or neurological morbidity. This case represents the first reported surgical treatment of an iatrogenic PCA pseudoaneurysm. Endovascular occlusion with coils was an option, but dolichoectatic morphology requires sacrifice of the P1 segment, with associated risks to the thalamoperforators and circumflex perforators. The SCA-PCA bypass was ideal because of low-flow demands. Like other in situ bypasses, it requires no dissection of extracranial arteries, no second incision for harvesting interposition grafts, and has a high likelihood of long-term patency. The SCA-PCA bypass is also applicable to fusiform SCA aneurysms requiring revascularization with trapping. This case demonstrates a dangerous complication that results from the limited view of the posterolateral surgical field through the endoscope and the imprecision of endoscopic instruments.


Sign in / Sign up

Export Citation Format

Share Document